New Grad in Intermediate Care?

[bewitched]

I've been working as a PCT (basically CNA) for the past seven months at a local hospital and the chances seem promising that I may be offered a position on nights on the Intermediate Care Unit after graduation in December, since I am precepting there and the unit director sounded interested. Now I'm not going to count my chicks before they hatch, but I would be thrilled to work on this unit due to a great team of co-workers whom I already know, familiarity with the unit and patient acuity, and the extensive orientation process--I want to feel prepared when I hit the floor on my own and I think this unit can give me that.

Our intermediate care unit is basically a step-down from ICU and a step up from the basic med surg unit. We get pts transitioning to the floor because their status is improving, and we get pts coming in from the rest of the hospital because their status is declining. Nurse to patient ratio is 1 nurse to 4 pts. We do take vents on occasion, trachs frequently, and drips fairly often.

Does this sound like a good place to get my feet wet in nursing care? Truthfully critical care nursing is my second choice after maternity/L&D nursing which I can't get into without at least a year of med-surg experience. But I am not the kind of person to do something half-@$$ed, if I took on this Intermediate position I would do everything I could to be the best intermediate care nurse I could be. What can I do to improve my critical care nursing knowledge prior to taking this position if it is offered? Are there any books you could suggest? I saw one of the intermediate care nurses studying from a textbook for her CCRN test, but the book had mostly Q&As, not a review of critical care nursing content...

I appreciate any and all input! I am not so overly confident as to think I can do anything and know everything right from the start, however, I don't want to bite off more than I can chew and end up endangering my patients with a lack of knowledge. I want to set myself up to succeed, and to give the best care that I can to my patients.

[turnforthenurse, MSN, NP]

Intermediate care is an excellent place to start, especially since iCU nursing is one of your interests. You get your cardiac stuff on a stepdown (and get exposed to the different arrhythmias, reading EKGs and how to treat, etc) along with your vent experience (but every unit is different...my unit does not take patients on vents and trachs are very rare) and drip experience. It would make for a good transition into ICU if that is the route you decide to go to later on. I work on an intermediate (progressive) care unit and started here as a new grad. I love my unit. I have learned so much and I'm always learning something new every day.

You can seek out your PCCN certification, or progressive care certified nurse, but you need to have a certain number of hours in order to qualify. The number of hours equate to about a year's worth of full-time experience. The AACN has progressive care materials and there is also the "Pass CCRN!" book by Dennison. As the title suggests it focuses on the CCRN but it can be an excellent review for the PCCN, too. The book is practically a full review in outline format with questions at the end to apply your knowledge and a CD full of practice questions.

Other good books would be books from the Made Incredibly Easy series: Critical Care Nursing and Cardiac Care.

[Deltaflaze]

Definitely do-able. I was a new grad this year and got a job working critical care float (ICU, ER, and IMCU). Just make sure to look things up and read evidence based research - don't just take what your preceptor says as law. No one knows everything, including the nurses who have been there a long time.